P123 TAPP - THE BEST APPROACH FOR INGUINAL HERNIA ASSOCIATED WITH ADULT CRYPTORCHIDISM: CASE REPORT AND LITERATURE REVIEW

Aim Cryptorchidism is a rare condition of adult male. The diagnosis is based on examination: impalpable testis and CT/MRI. The surgical correction of cryptorchidism is possible in childhood, but in adult orchiectomy is recommended, considering the malignancy risk. The association with hernia is uncommon. Material and Methods We report the case of a 23 years old male with left inguinal hernia and concomitant left cryptorchidism. MRI revealed the intra-abdominal left testicle, with reduced size and short vessels. Lab analysis were normal. We underwent laparoscopic exploration: the left testicle was small and had pelvic localization. A large inguinal hernia was also confirmed. We decided to perform laparoscopic TAPP (transaabdominal preperitoneal repair) and left orchiectomy. The evolution was uneventful and patient discharged 1st day postoperatively. Histology revealed testicular atrophy with no malignancy, also no spermatogenesis was present. No recurrence was found during follow-up. Results Cryptorchidism in adult is rare. The association with hernia is even more rare. The open management is not easy, often in pelvic/abdominal localization, the inguinal approach can be cumbersome. There is no standard of care for these cases, but we found the minimally invasive approach to be a good choice. Laparoscopic surgery has the advantage of enhanced exploration and orhidectomy can be easily performed. Associated with the orchidectomy, hernia cure can be facilitated by laparoscopic TAPP procedure. Conclusions In cases of concomitant hernia and cryptorchidism, we emphasize the idea of simultaneously cure hernia via laparoscopic TAPP procedure associated with orchidectomy as feasible and safe.

Open management of the umbilical cord According to M. L. Vydrin

The issue of caring for the umbilical cord has long been one of the most important issues in caring for a newborn. Now, when we can create a large aseptic environment around the newborn (sterile underwear, purified air), the method of open guidance of the umbilical cord proposed by prof. M. L. Vydrin.

Job preferences of undergraduate pharmacy students in China: a discrete choice experiment

Background Pharmacists are a crucial part of the health workforce and play an important role in achieving universal health coverage. In China, pharmaceutical human resources are in short supply, and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed light on future policy interventions. Methods A discrete choice experiment was conducted to assess the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyse data, and the final model was chosen according to the model fit statistics. A series of policy simulations was also conducted. Results In total, 581 respondents completed the questionnaire, and 500 respondents who passed the internal consistency test were analysed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of the workplace) and years to promotion. There was preference heterogeneity among respondents, e.g., male students preferred open management, and female students preferred jobs in public institutions. Furthermore, students with an urban background or from a single-child family placed higher value on a job in the city compared to their counterparts. Conclusion The heterogeneity of attributes showed the complexity of job preferences. Both monetary and nonmonetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attract graduates to work in rural areas should consider both incentives on the job itself and the background of pharmacy school graduates.

Analysis of Flood Disaster Mitigation in West Sumatra

Watershed development based on sustainable development requires open management that ensures the continuity of the coordination process between related institutions. This development is characterized by cross-sectoral and multidisciplinary. This research problem answers about 1) What is the cause of flooding in West Sumatra?; 2) What are the alternative mitigations for the flood disaster management?; 3) What are the impacts of the flood?; and 4) What are the strategic steps that can be taken?. The research study uses the library method, which is based on data obtained from the Agency of Regional Disaster Management (BPBD) West Sumatra Province in 2019. The results of this study indicate that the principles of disaster mitigation in West Sumatra have not been fully implemented, such as before a disaster, during a disaster, and after a disaster.

Extracorporeal sheath shunt technique in trauma: A different vascular shunt in civilian trauma

Background/Objective Temporary intravascular shunts are widely used in military surgery, representing a bridging until definitive vascular reconstruction. In civilian practice, shunts are mainly used as damage control and as a temporary measure until orthopaedic fixation. The objective of this report is to illustrate a new approach to the temporary restoration of perfusion during open management of extremity arterial injury. Methods The authors present a technique that uses sheaths introducers, instead of commercial or purpose-built shunts, which can be used through surgical or percutaneous approaches. Three clinical cases are presented where this technique was performed. Results/Conclusion: In the presented cases, this technique reduced time of shunt construction by avoiding artery surgical approach. This technique can facilitate the creation of an intravascular shunt among other than vascular surgeons.

Job Preferences of Undergraduate Pharmacy Students in China: A Discrete Choice Experiment

Background: Pharmacists are a crucial part of the health workforce and playing important role in achieving universal health coverage. In China, pharmaceutical human resources are in short and the distribution is unequal. This study aimed to identify the key job characteristics that influence the job preferences of undergraduate pharmacy students and to elicit the relative importance of different job characteristics to shed lights on future policy intervention.Methods: A discrete choice experiment was conducted to elicit the job preferences of undergraduate pharmacy students from 6 provinces in mainland China. A face-to-face interview was used to collect data. Conditional logit and mixed logit models were used to analyze data and the final model was chosen according to the model fit statistics. A series of policy simulation was also conducted.Results: In total, 581 respondents completed the questionnaire and 500 respondents who passed the internal consistency test were analyzed. All attributes were statistically significant except for open management. Monthly income and work location were most important to respondents, followed by work unit (which refers to the nature of workplace) and years to promotion. There exists preference heterogeneity among respondents, e.g. male students preferred open management and female students preferred a job in private institutions. Furthermore, students with an urban background or from a single-child family placed higher values on a job in the city as compared to their counterparts. Conclusion: The heterogeneity of attributes showed the complexity of job preferences. Both monetary and non-monetary job characteristics significantly influenced the job preferences of pharmacy students in China. A more effective policy intervention to attact graduates to work in rural areas should consider both incentives on the job itself as well as the background of pharmacy school graduates.